decisionhealth Newsletters, Part B News - 2012 Issue 9 (September)
Hang on to more revenue by tracking private pay reimbursement
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Article Overview
This article explains how providers can monitor private payer reimbursement, build and maintain their own fee schedules, and compare contracted payment against actual amounts paid. It is aimed at practices and billing teams that manage commercial payer contracts and want a better understanding of payer portals, contract tracking, and reimbursement analysis workflows. The piece also discusses general approaches to reviewing payer agreements, using spreadsheets or contract management systems, and preparing for renegotiation.
Why This Topic Matters
Private payer contracts and reimbursement patterns can vary widely, so failing to track them can lead to missed revenue or unnoticed underpayments. The article is relevant to practices trying to improve financial oversight, maintain accurate internal fee schedules, and manage payer-specific reimbursement data more effectively.
Article Sections
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Revenue cycle management
Introduces the topic of private payer reimbursement tracking and why maintaining internal fee schedules can be important for revenue cycle oversight.
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6 tips to build your own private payer fee schedules
Covers general methods for collecting reimbursement information, organizing payer data, and comparing contract terms across services and payers.
What You Will Learn
- Why private payer reimbursement tracking matters for revenue cycle management
- How providers can gather reimbursement information from payer portals and contracts
- How spreadsheet-based tracking can be used to compare expected and actual payment
- How contract management systems may help monitor payer reimbursement differences
- How practices can approach fee schedule review and renegotiation at a high level
Who Should Read This
- Physician practices
- Practice administrators
- Revenue cycle staff
- Billing and coding teams
- Managed care contracting staff
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